<!DOCTYPE html>
<html>
	<head>
		<meta charset="UTF-8">
		<title>ZUI-静姐姐-后台通用模板1</title>
		<link rel="stylesheet" href="css/zui.css" />
		<link rel="stylesheet" href="css/public.css" />
		<script type="text/javascript" src="js/jquery.min.js" ></script>
		<script type="text/javascript" src="js/zui.min.js" ></script>
	</head>
	<body>
		<div class="y-conRightmain scrollbar-hover">
			<ol class="breadcrumb y-borderB">
			  <li><a href="your/url/">Home</a></li>
			  <li><a href="your/url/">Library</a></li>
			  <li class="active">Data</li>
			</ol>
			
			<div class="y-bgfff y-padLR-20 y-padB-20 y-padT-10 card y-marT-10">
				<h3 class="y-borderB y-padB-10 y-marB-20 clearfix y-marT-10">
					<span style="line-height: 30px;">新增订单</span>
					<a class="btn btn-primary pull-right" onclick="javascript:history.back(-1);">返回列表</a>
				</h3>
				<div class="y-padT-20">
					<form class="form-horizontal">
						
						  <div class="form-group">
						    <label class="col-sm-2">用户名</label>
						    <div class="col-sm-2">
						      <input type="text" class="form-control" placeholder="品牌名称">
						    </div>
						    <div class="col-sm-2">
						      <select class="form-control">
						        <option>匿名用户</option>
						      </select>
						    </div>
						    <button type="submit" class="btn btn-primary">搜索</button>
						  </div>
						  <div class="form-group">
						    <label class="col-sm-2"><span class="text-danger">*&nbsp;</span>收货人</label>
						    <div class="col-sm-4">
						      <input type="text" class="form-control" placeholder="收货人名字" required>
						    </div>
						  </div>
						  <div class="form-group">
						    <label class="col-sm-2"><span class="text-danger">*&nbsp;</span>联系电话</label>
						    <div class="col-sm-4">
						      <input type="text" class="form-control" placeholder="收货人联系电话" required>
						    </div>
						  </div>
						  <div class="form-group">
						    <label class="col-sm-2"><span class="text-danger">*&nbsp;</span>地址</label>
						    <div class="col-sm-9">
						    	<div class="col-sm-2 y-padL0">
							      <select class="form-control">
							        <option>选择省份</option>
							        <option>河南省</option>
							      </select>
							    </div>
							    <div class="col-sm-2 y-padL0">
							      <select class="form-control">
							        <option>选择城市</option>
							        <option>郑州市</option>
							      </select>
							    </div>
							    <div class="col-sm-3 y-padL0">
							      <select class="form-control">
							        <option>选择区/县</option>
							        <option>金水区</option>
							      </select>
							    </div>
							    <div class="col-sm-5 y-padL0 y-padR0">
							      <input type="text" class="form-control" placeholder="详情地址" required="required">
							    </div>
						    </div>
						  </div>
						  <div class="form-group">
						    <label class="col-sm-2"><span class="text-danger">*&nbsp;</span>配送物流</label>
						    <div class="col-sm-2">
						      <select class="form-control">
						        <option>选择物流</option>
						        <option>申通物流</option>
						      </select>
						    </div>
						  </div>
						  <div class="form-group">
						    <label class="col-sm-2"><span class="text-danger">*&nbsp;</span>支付方式</label>
						    <div class="col-sm-4">
						      <select class="form-control">
						        <option>支付宝</option>
						        <option>微信</option>
						        <option>货到付款</option>
						      </select>
						    </div>
						  </div>
						  <div class="form-group">
						    <label class="col-sm-2">发票抬头</label>
						    <div class="col-sm-4">
						      <input type="text" class="form-control" placeholder="发票抬头" required="required">
						    </div>
						  </div>
						  <div class="form-group">
						    <label class="col-sm-2">添加商品</label>
						    <div class="col-sm-4">
						    	<button type="button" class="btn btn-primary" data-iframe="goodsSelect.html" data-toggle="modal" data-size="lg" data-height="400" data-moveable="true">选择商品</button>
						      	<!--<button type="button" class="btn btn-info btn-sm"><i class="icon-search"></i>选择商品</button>-->
						    </div>
						  </div>
						  <div class="form-group">
						    <label class="col-sm-2"><span class="text-danger">*&nbsp;</span>商品列表</label>
						    <div class="col-sm-10">
						    	<div class="table-responsive">
						    		<table class="table table-hover y-border">
									  <tbody>
									    <tr>
									      <td>爱普生EPSON WF-8593 A3+彩色打印机一体机复印机扫描传真 全金属支架落地式配置 原装正品</td>
									      <td class="text-red">23900.00元</td>
									      <td>100</td>
									      <td style="width: 70px;"><input class="form-control input-sm text-center" type="text" placeholder="购买数量" value="1"></td>
									      <td><button class="btn btn-sm" type="button">删除</button></td>
									    </tr>
									    <tr>
									      <td>爱普生EPSON WF-8593 A3+彩色打印机一体机复印机扫描传真 全金属支架落地式配置 原装正品</td>
									      <td class="text-red">23900.00元</td>
									      <td>100</td>
									      <td style="width: 70px;"><input class="form-control input-sm text-center" type="text" placeholder="购买数量" value="1"></td>
									      <td><button class="btn btn-sm" type="button">删除</button></td>
									    </tr>
									  </tbody>
									</table>
						    	</div>
						    </div>
						  </div>
						  <div class="form-group">
						    <label class="col-sm-2">管理员备注</label>
						    <div class="col-sm-4">
							    <div class="col-sm-12 y-padL0">	
							        <div class="y-padL0">
							      		<textarea class="form-control" rows="5" placeholder="可以输入多行文本"></textarea>
						      		</div>
						      </div>
						    </div>
						  </div>
						  <div class="form-group y-marT-10">
						    <div class="col-sm-offset-2 col-sm-4">
						      <button type="submit" class="btn btn-primary">确认提交</button>
						    </div>
						  </div>
					</form>
				</div>
			</div>
		</div>
	</body>
</html>
